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But on a day to day basis I'll confess that the concern about causing cancer by use of Xrays and CT isn't top of my priortity list. If a patient needs a CT due to a head injury then thats what they will have. I was interested therefore to read this article in the Lancet about "Radiaion exposred from CT scans in childhood and the subsequent risk of leukaemia and brain tumours".
The researchers did a retrospective analysis of children and young people under the age of 22 years without a previous diagnosis of cancer looking at radiation exposure from CT scans (using hospital imaging databases) and then the national cancer registries to evalaute the subsequent cancer diagnosis. A time delay was taken into consideration to allow for CT scans done for suspicion of cancer and dosage of radiation received was also taken into account.
Cancers were then broken down into different types and different body sites, and also considered by age of the patient at the time of exposure. The results showed an association between radiation exposure and both brain tumours and leukaemia and showed a considerable association for those who received more than one scan, with an estimate that in children under 15 receiving the equivalent radiation dose to 3 head CTs could triple the risk of brain tumour.
But I hear you ask "how many children receive more than 1 CT scan" but unfortunatley the answer is more than you would think. A head injury in a child if associated with particular features warrents a CT head. If there is also concerns about child protection associated with this you get a full skeletal survey (multi-directional xrays of every bone looking for fractures). If the CT shows changes then a follow up CT if often done a few days later looking for progression. For an accient prone child 3 CT scans is not unreasonable for a childhood of trouble. But taking all this into account while the risk if tripled, the absolute risk is still very low.
Given the evidence should we be consenting parents for the risk of cancer when we explain the CT scan to them? How many CT scans would you allow your child to have?